American Journal of Gastroenterology最新文献

{"title":"Supplementary Considerations on the Timing of Direct Oral Anticoagulants Resumption.","authors":"Xin Zhou, Xiaofeng Zhang, Yaling Li, Jun Li","doi":"10.14309/ajg.0000000000003188","DOIUrl":"https://doi.org/10.14309/ajg.0000000000003188","url":null,"abstract":"","PeriodicalId":7608,"journal":{"name":"American Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":8.0,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142798945","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment on \"Gallstone Disease Is Associated With an Increased Risk of Inflammatory Bowel Disease: Results From 3 Prospective Cohort Studies\".","authors":"Ziwei Gao, Jiachen Qi, Wei Ye","doi":"10.14309/ajg.0000000000003186","DOIUrl":"https://doi.org/10.14309/ajg.0000000000003186","url":null,"abstract":"","PeriodicalId":7608,"journal":{"name":"American Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":8.0,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142798693","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Arsenic Exposure in Celiac Disease: The Hidden Cost of a Gluten-Free Diet.","authors":"Tracey M DaFonte, Maureen M Leonard","doi":"10.14309/ajg.0000000000003203","DOIUrl":"https://doi.org/10.14309/ajg.0000000000003203","url":null,"abstract":"","PeriodicalId":7608,"journal":{"name":"American Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":8.0,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142798679","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Shared Decision Making in EoE.","authors":"Albert J Bredenoord, Bryan G Sauer","doi":"10.14309/ajg.0000000000003204","DOIUrl":"https://doi.org/10.14309/ajg.0000000000003204","url":null,"abstract":"","PeriodicalId":7608,"journal":{"name":"American Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":8.0,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142783908","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"When Subtraction Wins, What Are the Considerations for Addition in Helicobacter pylori Eradication?","authors":"Qingzhou Kong, Yueyue Li","doi":"10.14309/ajg.0000000000003183","DOIUrl":"https://doi.org/10.14309/ajg.0000000000003183","url":null,"abstract":"","PeriodicalId":7608,"journal":{"name":"American Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":8.0,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142765522","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Continuing Medical Education Questions: December 2024.","authors":"Fady Georges Haddad","doi":"10.14309/ajg.0000000000003164","DOIUrl":"https://doi.org/10.14309/ajg.0000000000003164","url":null,"abstract":"<p><p>Article Title: Risk Factors for Inadequate Bowel Preparation in Colonoscopy: A Comprehensive Systematic Review and Meta-Analysis.</p>","PeriodicalId":7608,"journal":{"name":"American Journal of Gastroenterology","volume":"119 12","pages":"2371"},"PeriodicalIF":8.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142765524","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Distinguishing Features of Autoimmune Gastritis Depending on Previous Helicobacter pylori Infection or Positivity to Anti-Parietal Cell Antibodies: Results From the Autoimmune gastRitis Italian netwOrk Study grOup (ARIOSO).","authors":"Marco Vincenzo Lenti, Emanuela Miceli, Edith Lahner, Gabriele Natalello, Sara Massironi, Annalisa Schiepatti, Fabiana Zingone, Valentina Sciola, Roberta Elisa Rossi, Renato Cannizzaro, Elena Maria De Giorgi, Virginia Gregorio, Erica Fazzino, Antonella Gentile, Clarissa Petrucci, Emanuele Dilaghi, Giulia Pivetta, Alessandro Vanoli, Ombretta Luinetti, Marco Paulli, Andrea Anderloni, Maurizio Vecchi, Federico Biagi, Alessandro Repici, Edoardo Vincenzo Savarino, Shamim Joudaki, Mariangela Delliponti, Alessandra Pasini, Federica Facciotti, Fabio Farinati, Mario Milco D'Elios, Chiara Della Bella, Bruno Annibale, Catherine Klersy, Gino Roberto Corazza, Antonio Di Sabatino","doi":"10.14309/ajg.0000000000002948","DOIUrl":"10.14309/ajg.0000000000002948","url":null,"abstract":"<p><strong>Introduction: </strong>To describe the clinical features and the risk of developing gastric tumors in patients with autoimmune gastritis (AIG).</p><p><strong>Methods: </strong>This was a retrospective, longitudinal, multicenter study conducted at 8 Italian tertiary referral centers. We retrieved clinical data from all histologically proven patients with AIG. Differences between Helicobacter pylori -exposed vs H. pylori -naive and anti-parietal cell antibody (PCA)-positive vs PCA-negative patients were investigated. The rate of gastric adenocarcinoma and type 1 gastric neuroendocrine neoplasm (gNEN) was assessed. A multivariable model for factors associated with gNEN was fitted.</p><p><strong>Results: </strong>A total of 1,598 patients with AIG (median age 58 years, interquartile range 46-68; F:M ratio 2.7:1) were included. H. pylori -naive patients were more likely to have a first-degree family history of AIG (14.7% vs 8.9%; P = 0.012), type 1 diabetes mellitus (4.9% vs 2.3%; P = 0.025), and pernicious anemia (30.9% vs 21.1%; P = 0.003). PCA-positive patients had significantly more associated autoimmune diseases (59.0% vs 42.9%; P < 0.001) and were more likely to have been diagnosed by a case-finding strategy (15.3% vs 2.6%; P < 0.001). Overall, 15 cases (0.9%) of gastric adenocarcinoma and 153 cases (9.6%) of gNEN occurred, with a global rate of 0.12 (95% confidence interval [CI] 0.07-0.20) and 1.22 (95% CI 1.03-1.42) per 100 person/year, respectively. Having a vitamin B12/iron deficiency manifestation at AIG diagnosis was associated with a 16.44 (95% CI 9.94-27.20 P < 0.001) hazard ratio of gNEN.</p><p><strong>Discussion: </strong>The \"pure\" AIG pattern has typical features of an autoimmune disease and seems to be unrelated to H. pylori . In a tertiary referral setting, the risk of developing overt gastric adenocarcinoma is low, while patients with vitamin B12 deficiency complications at onset may benefit from a more intense endoscopic follow-up for early gNEN detection.</p>","PeriodicalId":7608,"journal":{"name":"American Journal of Gastroenterology","volume":" ","pages":"2408-2417"},"PeriodicalIF":8.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141557816","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and Validation of a Tool for Assessing Adherence to Gluten-Free Diet in Patients With Celiac Disease.","authors":"Wajiha Mehtab, Anita Malhotra, Ashish Upadhyay, Namrata Singh, Ashish Agarwal, Ashish Chauhan, Shubham Mehta, Anam Ahmed, Alka Singh, V Sreenivas, Anupa Siddhu, Vineet Ahuja, Govind K Makharia","doi":"10.14309/ajg.0000000000002911","DOIUrl":"10.14309/ajg.0000000000002911","url":null,"abstract":"<p><strong>Introduction: </strong>Life-long adherence to gluten-free diet (GFD) and its assessment is essential for patients with celiac disease (CeD). We have developed and validated a tool for assessing adherence to GFD which can be used by both physicians and dietitians.</p><p><strong>Methods: </strong>Phase 1: Development, content validation, and assessment of reliability of tool. Phase 2: Validation of tool against standard dietary evaluation (SDE) (gold standard), immunoglobulin A - anti-tissue transglutaminase antibodies (IgA anti-tTG Ab), and gluten immunogenic peptides in urine. Overall, 380 biopsy-confirmed patients with CeD (derivation cohort: n = 100 [phase 1], n = 210 [phase 2] and independent validation cohort, n = 70) were recruited.</p><p><strong>Results: </strong>Of an initial 90-point questionnaire, 84 items (Celiac Disease: Compliance Assessment Test [CD-CAT.v1]) were retained after content validation and pilot testing. In phase 1, upon administering CD-CAT.v1 on 100 patients, a comprehensive 35-item tool (CD-CAT.v2; α = 0.86) was obtained after removing items with low test-retest reliability and item-rest correlation values. In phase 2, upon administering CD-CAT.v2 on 210 patients, 22 items were removed having low correlation values (R < 0.4) with SDE. Finally, a 13-item tool (CD-CAT.v3; α = 0.84) was obtained with high criterion validity with SDE ( r = 0.806, P < 0.001), moderate convergent validity with celiac disease adherence test ( r = 0.602, P = 0.007), and moderate to weak correlation with urine gluten immunogenic peptides ( r = 0.46, P = 0.001) and IgA anti-tTG Ab ( r = 0.39, P = 0.008), respectively. The final 13-item tool also strongly correlated with SDE ( r = 0.78, P < 0.001) in an independent validation cohort of 70 patients with CeD. Principal component analysis identified 3 relevant subscales with a cumulative variance of 62%. The sensitivity and specificity of CD-CAT.v3 were 80% and 91%, respectively, with an area under curve of 0.905 with SDE. The obtained cutoff score of <19 from the receiver operating characteristic curve was further categorized as 13 = excellent, 14-18 = very good, 19-28 = average, and >28 = poor adherence to GFD.</p><p><strong>Discussion: </strong>CD-CAT is a new and rapid tool for monitoring dietary adherence to GFD with high sensitivity and specificity, which can be administered by both physicians and dietitians.</p>","PeriodicalId":7608,"journal":{"name":"American Journal of Gastroenterology","volume":" ","pages":"2501-2509"},"PeriodicalIF":8.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141454645","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychiatric Disorders Among 5,800 Patients With Microscopic Colitis: A Nationwide Population-Based Matched Cohort Study.","authors":"David Bergman, Bjorn Roelstraete, Jiangwei Sun, Fahim Ebrahimi, Agnieszka Butwicka, Darrell S Pardi, Jonas F Ludvigsson","doi":"10.14309/ajg.0000000000002955","DOIUrl":"10.14309/ajg.0000000000002955","url":null,"abstract":"<p><strong>Introduction: </strong>Microscopic colitis (MC) is an inflammatory condition of the large intestine. Primarily diagnosed in middle-aged and older adults, the incidence of the disease has increased markedly during the past few decades. While MC is associated with a reduced quality of life, large-scale studies on the association with future psychiatric disorders are lacking.</p><p><strong>Methods: </strong>We conducted a nationwide matched cohort study in Sweden from 2006 to 2021. Through a nationwide histopathology database (the Epidemiology Strengthened by histoPathology Reports in Sweden study), we identified 5,816 patients with a colorectal biopsy consistent with MC. These patients were matched with 21,509 reference individuals from the general population all of whom with no previous record of psychiatric disorders.</p><p><strong>Results: </strong>From 2006 to 2021, 519 patients with MC (median age 64.4 years [interquartile range = 49.5-73.3]) and 1,313 reference individuals were diagnosed with psychiatric disorders (9.9 vs 6.5 events per 1,000 person-years), corresponding to 1 extra case of psychiatric disorder in 29 patients with MC over 10 years. After adjustments, the hazard ratio for psychiatric disorders was 1.57 (95% confidence interval = 1.42-1.74). We found significantly elevated estimates up to 10 years after MC diagnosis and a trend toward higher risk with increasing age. Specifically, we observed increased risks for unipolar depression, anxiety disorders, stress-related disorders, substance abuse, and suicide attempts. In sibling-controlled analysis, the adjusted hazard ratio was 1.76 (95% confidence interval = 1.44-2.15).</p><p><strong>Discussion: </strong>Patients with MC are at increased risk of incident psychiatric disorders compared with the general population.</p>","PeriodicalId":7608,"journal":{"name":"American Journal of Gastroenterology","volume":" ","pages":"2516-2525"},"PeriodicalIF":8.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141589357","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk Factors for Inadequate Bowel Preparation in Colonoscopy: A Comprehensive Systematic Review and Meta-Analysis.","authors":"Azizullah Beran, Tarek Aboursheid, Adel Hajj Ali, Hashem Albunni, Mouhand F Mohamed, Alejandra Vargas, Nwal Hadaki, Saqr Alsakarneh, Douglas K Rex, John J Guardiola","doi":"10.14309/ajg.0000000000003073","DOIUrl":"10.14309/ajg.0000000000003073","url":null,"abstract":"<p><strong>Introduction: </strong>Inadequate bowel preparation (IBP) before colonoscopy remains a common problem. This meta-analysis aimed to assess the risk factors associated with IBP.</p><p><strong>Methods: </strong>We searched multiple databases for studies that assessed risk factors for IBP after adjustment and reported the data as adjusted odds ratios with 95% confidence intervals. Meta-analyses were conducted using a random-effects model, and pooled adjusted odds ratios for risk factors reported in ≥ 3 studies were constructed.</p><p><strong>Results: </strong>One hundred fifty-four studies with 358,257 participants were included. We analyzed 48 unique risk factors. Sociodemographic predictors of IBP were Medicaid insurance, obesity, current tobacco use, age ≥ 65 years, Black race, low education level, male sex, and unmarried status. Comorbidity-related predictors of IBP were any psychiatric disease, cirrhosis, American Society of Anesthesiologists (ASA) class ≥ 3, poor functional status, constipation, diabetes, previous abdominopelvic surgery, and hematochezia. Medication-related predictors of IBP were tricyclic antidepressants, antidepressants, opioids, nontricyclic antidepressants, and calcium channel blockers. Preparation/procedure-related predictors of IBP were brown liquid rectal effluent, any incomplete bowel preparation (BP) intake, lack of split-dose BP, increased BP-to-defecation interval, any nonadherence to dietary instructions, increased BP-to-colonoscopy interval, any BP intolerance, previous IBP, and inpatient status. Although afternoon colonoscopy was a predictor of IBP, subgroup analysis of prospective studies revealed no significant association.</p><p><strong>Discussion: </strong>Our meta-analysis focused on adjusted risk factors to provide precise estimates of the most important risk factors for IBP. Our findings could help develop a validated prediction model to identify high-risk patients for IBP, improve colonoscopy outcomes, reduce the need for repeat colonoscopies, and reduce associated healthcare costs.</p>","PeriodicalId":7608,"journal":{"name":"American Journal of Gastroenterology","volume":" ","pages":"2389-2397"},"PeriodicalIF":8.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142118814","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}